Care Of Prostate Cancer Patients In Selected Urology Clinics In Nairobi County

ABSTRACT

Prostate cancer is an adenocarnoma of significant reproductive health burden in the world. Of the thirteen million cancer cases in the world, prostate cancer accounts for nine hundred thousand cases translating to 13.6% of the total cases and ranks as 5th most common cancer. The mortality rate among black population is 19 per 100,000 while among the Asian populations is 2.5 per 100,000.In Africa, of the six hundred thousand cancer cases reported, prostate cancer accounts for thirty four thousand cases and is responsible for twenty four thousand deaths ranking 6th cause of death among men. In Kenya, twenty eight thousand cancer cases are reported and of these, prostate cancer accounts for 15.3% incidence of the total and causes a mortality of eight hundred and fifty effective management of prostate cancer is largely dependent on early diagnosis, prompt treatment and follow up. However, due to lack of policy and adherence treatment protocols in Kenya, prostate cancer deaths have remained high. The study objectives were; to determine the availability, type and usage of standard clinical protocols in selected urology, to evaluate the urologist’s characteristics that influence prostate cancer care in selected urology and to establish the Socio-demographic characteristics of prostate cancer patients attending selected urology clinics within Nairobi County. Therefore, the study was descriptive cross sectional study which evaluated the care of prostate cancer patients in selected urology clinics within Nairobi County. The study established the existing discourse on prostate cancer management and practices. A total of 156 patients and 13 urologists were enrolled into the study. It enrolled all the patients with a diagnosis of prostate cancer and were undergoing treatment at the various urology clinics. Structured questionnaires were used to collect social demographic data and data on availability and usage of prostate cancer protocols. Clinical information such as biometric values from the study participants were also recorded in the questionnaires. Data was cleaned and coded, dual entered in SPSS version 20.chi-square was used in determining associations between the urology characteristics and usage of protocols. Categorical data such as tumor grade and PSA levels were summarized using contingency tables and bar charts, quantitative data was summarized using proportions, medians, means, tabulated and graphed. The findings revealed that the common clinical protocols in selected clinics in Nairobi County are the WHO (38.5%) and MOH protocols(38.5%) . Patient variables like age, income, mode of payments influence the choice of urologist but do not affect the care given. The study recommends that; WHO and MOH protocols should be fully adhered to ensure optimum cancer care, government should ensure equity in access through subsiding and ensuring that prostate cancer is covered under a medical scheme. There is also need to expand prostate cancer research to other Kenyan regions especially at county level to identify the unique factors influencing care to formulate relevant and specific targeted interventions for the disease.